In Poland, the therapeutic modality of Electroconvulsive Therapy (ECT) boasts a history spanning over seven decades. Despite its documented therapeutic efficacy and safety profile, its integration into clinical practice remains suboptimal. Recent data elucidates a marked paucity in the utilization rate of ECT in Poland. Therefore, it is imperative to discern the barriers impeding its broader adoption of this potentially life-saving treatment.

The aim of this study is to investigate the attitude of early career psychiatrists towards ECT and its place in clinical practice in Poland.

A web-based, anonymous survey was conducted, targeting early career psychiatrists in Poland. The questionnaire, part of an international study, consisted of 36 multiple-choice and Likert scale questions.

The majority of respondents emphasised the importance of further educational opportunities related to ECT, seeing it as a safe, effective, and possibly lifesaving procedure. Most of them benefited from ECT training during their residency, however less than a half had the opportunity to administer ECT themselves. They exhibited an interest to introduce ECT into their therapeutic repertoire, depending on the provision of requisite financial and infrastructural support.

There is a palpable eagerness among early career psychiatrists in Poland to enhance their proficiency in ECT. A robust curriculum, encompassing both theoretical discourse and hands-on ECT training, is paramount for all psychiatry trainees. Concurrently, there is a pressing need to formulate national ECT guidelines within Poland, which could potentially ameliorate apprehensions surrounding this procedure.

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Psychosurgical procedures gained an infamous reputation during the 20th century with the implementation of the lobotomy as treatment for several psychiatric illnesses. However, modern-day psychosurgery is a flourishing field that provides valid treatment alternatives to neuropsychiatric patients thanks to increasingly accurate and safe stereotactic procedures. As more than 80% of people with mental disorders reside in Low and Middle Income Countries (LMICs), investigating the impact of psychosurgical procedures has a global relevance. People living in LMICs are exposed to a variety of stressors which could facilitate the development of psychiatric and neurological diseases. The immense gap that still exists between the population of LMICs and adequate medical and surgical care is an important obstacle to the reduction of global mental health burden. A scoping review will be conducted to investigate the extent of the existing literature and identify key themes, challenges and research gaps on the implementation and outcomes of psychosurgery in LMIC settings.

• - To comprehensively map the existing literature: Provide an extensive overview of the literature on the use of psychosurgery in low and middle-income countries.

• - To identify key themes: Recognize recurring themes and topics within the literature related to psychosurgery in these settings.

• - To assess challenges: Analyze the challenges and barriers associated with the implementation of psychosurgery in resource-constrained contexts.

• - To identify research gaps: Highlight areas within the existing literature where further research is needed to enhance our understanding of psychosurgery in low and middle-income countries.

The methodology consists of five stages, consistent with Arksey and O’Malley’s framework. Using the PICO model, the Research Question, Inclusion/Exclusion Criteria and search methods were developed. Electronic Medical Databases (Medline OVID, Cochrane Library, Embase, PubMed, Scopus) will be searched for relevant studies. The PRISMA-ScR framework is used to guide the reporting process. Quantitative and Qualitative data will be extracted, including key information such as study type, demographics and methods used to assess the outcomes of psychosurgical interventions. Data will be presented discursively, supported with statistics and graphs where appropriate. No ethical approval is required.

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The results will be useful to healthcare professionals in LMICs involved in neuropsychiatric care, evaluating the current uses of psychosurgery and their potential benefit for the affected population whilst highlighting gaps in knowledge with the aim of propelling further research.

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In the context of treatment-resistant bipolar depression, the use of neuromodulation techniques, notably transcranial magnetic stimulation (TMS), has been on the rise, particularly in the treatment of mood disorders. TMS involves the generation of a strong pulsed magnetic field through an electromagnet placed near the skull, thereby inducing an electrical field capable of depolarizing nerve cell membranes (Dolberg et al., 2001). The magnetic nature of TMS carries advantages compared to direct electric stimulation, such as fewer side effects, reduced invasiveness, and precise targeting. Nevertheless, it is not without its risks. Reported concerns include the induction of manic or hypomanic states, particularly in individuals with bipolar disorder, as well as unipolar depression (Sakkas et al., 2003; Ozten et al.,2013; Knox et al 2021).

This review aims to assess the safety and viability of TMS as a therapeutic option and how to best optimize its clinical use.

A comprehensive literature review was conducted utilizing resources from Pubmed, Researchgate, and Google Scholar.

Despite some inconsistencies and potential confounding factors, our findings suggest that TMS may not significantly elevate the risk of manic switching, especially when compared to conventional treatments like antidepressants. However, it may potentially induce manic episodes, particularly when used as monotherapy or in combination with other treatments. Variables such as treatment protocol and prior response to medication may contribute to mood switching risk. Proposed safety measures include personalized protocol design, close patient monitoring and the combination with mood-stabilizing medication.

Transcranial magnetic stimulation has been associated with manic and hypomanic episodes in mood disorder patients. While the evidence remains limited, it appears that certain individuals may be more susceptible to mood switching. Nevertheless, further research is needed to better elucidate variables influencing mood switching during TMS treatment and to develop effective preventative measures, especially for patients already predisposed to manic switching.

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The multifamily group that has been underway since April 2019 in Alcobendas, Madrid is described. A group that serves people diagnosed with mental disorder and their families, with the aim of improving their health and quality of life. It is about facilitating and improving the basic communication of relational aspects and healthy bonds. It is intended to offer a space where you can think together about the experiences lived in your own family with the rest of the group

Assess the evolution and improvement of the patient and family members with the Score 15 questionnaire, The Score is a way of giving users a voice about the therapy process, not about the contents of their problems, but about their perception of the effectiveness of therapeutic work and for professionals it is an opportunity to obtain important feedback from their work.

Using the Score !5 questionnaire on all participants in the group at time zero and after 12 sessions

Improvement in the family description items, and in the quantitative improvement in scoring of the following questions: What degree of severity would indicate? Do you think therapy will be helpful/has it been helpful to you?

Family therapy in the modality of Multifamily Groups provides an improvement in intrafamily communication, its links and therefore in the rest of social communication, facilitating the exit from loneliness and misunderstanding and in turn broadens the understanding and understanding by therapists

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Virtual Reality (VR) is a transformative technology that facilitates the development of immersive virtual environments. Its application is steadily growing within Cognitive Behavioral Therapy (CBT) techniques, notably in virtuo exposure therapy. This is particularly evident in the treatment of specific phobias, with a specific focus on addressing blood-injection-injury phobias.

The objective of our study is to design a treatment protocol for patients suffering from blood phobia based on VR.

We used the following scales:

• - Fear Survey Schedule-III (FSS-III) and the Injection Phobia Scale (IPS) for psychometric evaluation of the intensity of avoidance fear.

• - Questionnaire on cybersickness: to identify potential adverse effects of exposure to virtual reality.

To conduct a functional analysis of phobias, we used the SECCA grid and the SORC grid.

The therapeutic protocol stages of VR for a patient suffering from Blood-Injection-Injury Phobia (BIIP) are as follows:

1. 1. Collection of sociodemographic and clinical data.

2. 2. Functional analysis to identify triggering factors, contributing factors, and consequences of behavior. The SECCA or SORC grid can help in conducting this functional analysis.

3. 3. Psychometric evaluation of the intensity of avoidance fear using the three scales: FSS-III, IPS, and the cybersickness scale.

4. 4. Patient education on the mechanisms of the phobia.

5. 5. Setting of objectives.

6. 6. Therapeutic contract.

7. 7. The Protocol :

8. 8. Cognitive approach: identification of automatic thoughts and replacement with more rational thoughts.

9. 9. Behavioral approach: Progressive exposure, controlled immersion of the patient in virtual environments corresponding to situations that trigger their phobia. This exposure is coupled with relaxation.

The treatment continues with regular follow-up to ensure the consolidation of progress and to adjust strategies.

For relapse prevention, simple measures ,like personalized exercises to be done by the patient, can favor the long-term maintenance of the acquired skills.

Virtual reality exposure therapies (in virtuo) are as effective as in-vivo therapies. Besides, they offer a significant advantage over the latter as they facilitate access to stimuli or anxiety-provoking situations that are difficult to access or control in the real world.

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Rational Emotive Behavior Therapy (REBT) fundamentally posits that our thoughts, beliefs, and interpretations exert substantial influence over how we perceive and react to life’s occurrences. Central to REBT is the process of recognizing and disputing irrational, self-defeating beliefs, in favor of adopting rational and constructive perspectives.

This presentation endeavors to introduce the foundational principles of REBT, elucidate its applied techniques, demonstrate its efficacy through compelling case studies, and delineate its spheres of applicability.

Case Studies:

1. 1. Overcoming Social Anxiety: Illustrating the transformation from debilitating social anxiety to enhanced social functioning.

2. 2. Managing Work-related Stress: Exemplifying the alleviation of chronic stress in a high-pressure work environment.

3. 3. Overcoming Depression: Demonstrating the journey from persistent despondency to restored vitality and engagement.

In total, REBT furnishes a methodical and pragmatic approach to therapy, affording individuals agency in steering their emotional well-being towards positive and enduring transformation. It is imperative to acknowledge that the suitability of REBT hinges on the idiosyncratic needs, inclinations, and circumstances of each patient.

By internalizing and applying these foundational principles, REBT empowers individuals to identify and dispute irrational beliefs, paving the way for more adaptive emotional responses and an enhanced overall state of mental well-being. It equips individuals with tangible tools to navigate life’s challenges with heightened resilience and emotional equilibrium.

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Eating disorders are a group of pathologies in which negative beliefs about food, body type and weight are associated with conducts that include food restriction, binge eating, excessive exercise, induced vomiting and the use of laxatives. They can be really severe, affecting quality of life and lead to multiple physical and psychiatric complications, even with a deadly fate.

Presentation of a patient’s case with an eating disorder and the intervention with her family, as well as, doing a review of the family interventions in these kinds of patients.

Presentation of a patient’s case and review of existing literature, in regards to the use of family therapy in patients with eating disorders and its effects.

As in the patient’s case, there are a lot of studies that support the evidence of improvement using family therapy in patients with eating disorders. However, the difficulty to isolate the necessary variables in order to do studies about psychological treatments, complicates finding scientific evidence that supports the clinical evidence that we see in our patients day by day with these types of interventions.

There are studies that support the efficacy of these types of family interventions. However, there needs to be a more thorough investigation with the objective of finding the more precise optimal family intervention, and specifically, determining for who and under what conditions, certain types of family interventions would be more effective.

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Attendance at university can result in social support network disruption. This can have a negative impact on the mental health of young people. Demand for mental health support continues to increase in universities, making identification of factors associated with poorer outcomes a priority. Although social functioning has a bi-directional relationship with mental health, its association with effectiveness of psychological treatments has yet to be explored.

To explore whether students showing different trajectories of change in social function over the course of treatment differed in eventual treatment outcome.

Growth mixture models were estimated on a sample of 5221 students treated in routine mental health services. Different trajectories of change in self-rated impairment in social leisure activities and close relationships (Work and Social Adjustment Scale (WSAS) items 3 and 5) during the course of treatment were identified. Associations between trajectory classes and treatment outcomes were explored through multinomial regression.

Five trajectory classes were identified for social leisure activity impairment (Figure 1), and three classes were identified for close relationship impairment (Figure 2). For both measures the majority of students remained mildly impaired (Class 1). Other trajectories included severe impairment with limited improvement (Class 2), severe impairment with delayed improvement (Class 3), and, in social leisure activities only, rapid improvement (Class 4), and deterioration (Class 5). There was an association between trajectories of improvement in social functioning over time and positive treatment outcomes. Trajectories of worsening or stable severe impairment were associated with negative treatment outcomes.

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Changes in social functioning impairment are associated with psychological treatment outcomes in students, suggesting that these changes may be associated with treatment effectiveness or recovery experiences. Future research should look to establish whether a causal link exists to understand if additional benefit for students can be gained through integrating social support within psychological treatment.

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Functional pathological crying is a complex psychic phenomenon which poses both diagnostic and management challenges to the psychiatrist and psychotherapist. Apart from treatment with medications when clinically indicated, psychodynamic psychotherapy can be useful to understand the aetiology and to address these psychological issues faced by patients.

In this case report, psychodynamic psychotherapeutic techniques are employed to examine and manage functional pathological crying.

Ms L was a 33-year-old Chinese single woman who presented with mixed depressive and anxiety symptoms associated with frequent severe bouts of wailing. She had a history of parental neglect and childhood sexual abuse. Following psychiatric assessment, she was diagnosed with Mixed Depressive and Anxiety Disorder, and Borderline Personality Disorder. She was treated with Sertraline 50mg every morning and was referred for psychodynamic therapy.

Building trust and rapport with Ms L was crucial so that the therapeutic relationship could be utilized as a vehicle for change through earned attachments. Helping her appreciate how present experiences reflect conflicts from her past and addressing her defence mechanisms with the aims of expression of emotions, exploring her wishes and fantasies to access unconscious conflicts were important. These build greater self-awareness which helped her to develop the capacity for emotional self-regulation, bringing about an increase in her level of adaptation to stressors.

During the early phase of therapy, Ms L would be wailing throughout most of the therapy hour. As therapeutic rapport and trust were established, she began to open up about her abuse for us to explore her conflicts and complex emotions associated with it.

The key themes that emerged were her chronic low self-esteem with fears of authorities and abandonment, the tendency to take up a defended regressive helpless child-like position whenever feelings related to the abuse were rekindled, as well as the manifestation of these complicated psychic experiences in the form of a complex wailing phenomenon.

The functional pathological crying was a mixture of an expression of her challenging conflictual painful feelings, symbolic expression of her cry for help, repressive and regressive child-like emotional states as well as having a defensive function to avoid coming in touch with painful feelings.

Through therapy, Ms L was able to make better sense of her wailing, develop the capacity for emotional self-regulation by adopting a healthier adult position in responding to difficult feelings when triggered, learning to forgive herself and others, assume better self-care and improved relationships with others.

Through psychodynamic psychotherapy, complex functional pathological crying can be better understood and managed to bring about intra-psychic and interpersonal functional improvements.

None Declared

Schizophrenia is a chronic mental illness that has a lifetime prevalence worldwide of about 1% regardless of culture, social class and race. This implies that it affects a large number of families. Family therapy has been used for years as a promising approach to intervene with people suffering from such pathology. It has been shown that families with a high level of hostility, critical comments and over-involvement are related to a higher number of relapses in the family member diagnosed with schizophrenia.

The objectives are to examine whether systemic interventions could help to decrease the emotion expressed in these family members and thus decrease the number of relapses of patients as an alternative to pharmacological treatment.

A case report and a literature review on the impact of family therapy in patients with a diagnosis of schizophrenia. The search strategy included keywords such as “family intervention”, “schizophrenia” and “systemic therapy”. Selection criteria included randomized controlled trials (RCTs) and meta-analyses published between 2010 and 2021. Studies focused on the impact of family intervention on symptom management, relapse prevention and general functioning were included.

The findings consistently demonstrated the effectiveness of family intervention in improving outcomes for people with schizophrenia. These interventions generally involved psychoeducation, communication skills training, problem-solving techniques, and emotional support for family members. Results showed significant reductions in symptom severity, decreased relapse rates, improved adherence to pharmacological treatment, and better overall functioning among people who received family intervention compared with those who received only standard care. In addition, family intervention was associated with reduced caregiver burden, improved family communication, as well as increased knowledge about schizophrenia and its management.

Family intervention has become a valuable adjunctive treatment for people with schizophrenia. The findings of this review highlight its positive impact on symptom management, relapse prevention, and overall functioning. Family intervention offers a holistic approach that recognizes the importance of involving and supporting the family system in the treatment process. This intervention provides families with the tools and resources necessary to effectively cope with the challenges associated with schizophrenia and promotes a supportive and nurturing environment for the individual. Future research should focus on long-term outcomes and implementation of the family intervention in routine clinical practice.

None Declared

Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD) are among the ten most disabling disorders, yet only 30-40% of people with the condition seek specialist care (WHO). Considered a relatively new tool in the treatment of OCD and MDD, repetitive transcranial magnetic stimulation (rTMS) was first used by our team 1 year ago. Based on current literature cognitive behavioural therapy (CBT) is effective in 60% of OCD cases, with MDD also having a good response rate of 50-60%. The efficacy of SSRI’s has been demonstrated, but side effects can have a negative impact on adherence in the long term. Prolonged use of certain drugs has adverse reactions that lead specifically to memory impairment, which compromises suitability for psychotherapy. The same problem applies to the use of electroconvulsive therapy (ECT) in a major depressive episode.

Our aim was to study the efficacy of combining rTMS with CBT, to gather clinical experience on how these two different methods work in practice when combined.

Patients diagnosed with therapy resistant MDD received rTMS treatment using 50Hz theta burst over 10 sessions. Therapy resistant OCD patients were treated by a 15 sessions rTMS using 1Hz single pulse. These rTMS sessions were combined with CBT, of which we would like to highlight two cases: one of them is a 34 years old woman, who has wide range of sexual, checking and contamination-related OCD symptoms and only received SSRI treatment so far. The other one is a 29 years old man, who suffers from religious obsessions, cleaning compulsions and other repetitive behaviours.

The positive effects of rTMS treatment on working memory functions, attentional capacity and cooperative skills without significant additive effects suggest exciting possibilities for combining the two treatments, thus the combined treatment has been tested in clinical practice. In our own patient care, an important experience was that patients were committed to the therapy, felt safe and, unlike with medications, did not have to worry about side effects. While medication and ECT can make psychotherapy more difficult in the long term - mainly because of memory problems - rTMS facilitates it. Patients appreciate that we approach their problems in a complex way, and they perceive that the combination of the two very different methods reflects professionalism. Our poster attempts to present the experience of combining rTMS and CBT from the therapist’s perspective through two case studies.

Based on our experiences it is an effective approach to combine rTMS with CBT in therapy resistant MDD and OCD patients. In the light of these results the revision of the existing guidelines are considerable.

Acknowledgements

This study has been supported by the Human Resource Development Operating Programme 5.2.6 grant.

None Declared

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by communication impairments and difficulties in social interaction. These impairments can affect relationships with family members, increase stress and frustration for both the patient and family members, and contribute to behavioral disturbances in these patients. They are frequently associated with high rates of psychiatric comorbidity.

Given the impact of this disorder on the family unit, we set out to assess the clinical effectiveness of systemic family therapy, its influence on improving communication and coping with this disorder, strengthening relationships and mental health in these patients and their families.

A literature review was performed by searching for articles in Pubmed on May 24, 2023, focusing the terminology used on “Autism Spectrum Disorder” and “Systemic Family Therapy”. The search was limited to full text articles in English and Spanish, published in the last 10 years.

Several authors have stated that systemic family therapy could be beneficial:

• - Providing education.

• - Reporting additional educational resources.

• - Focusing sessions on improving social and communication skills, mood and coping behaviors.

• - Providing therapy to all family members to cope with this disorder and what it implies. It will be very important that the patient with ASD understands his condition and can receive support from his family, working with siblings on the bonding and coping with this condition.

• - Contributing to facilitate mourning the loss of the condition of “neurotypical” person, exploring emotions, feelings and belief systems, valuing the social and cultural context of the family.

Reviewing a variety of literature on this therapeutic approach, the authors concluded that “strategic, narrative and structural interventions can be applied from multiple approaches, especially suited to the challenges often faced by patients with ASD and their families”. Therapeutic work needs to involve different family members at different times. Therapeutic conversations will consider the child, the family and the family unit in context. Studies so far have not been able to establish whether particular systemic approaches have more favorable outcomes than others, which warrants further research.

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Currently, Ketamine is the only safe, effective, and widely used psychedelic-like medicine in Canada. It has demonstrated notably efficacy in providing relief to those experiencing treatment resistant mental health conditions. Pairing Ketamine treatment with psychotherapy, known as Ketamine Assisted Therapy (KAT), has been shown to yield more enduring outcomes. Work by Greenway et al. has demonstrated that playing music following ketamine administration for patients with bipolar disorder can help the patient feel more in control and reduce discomfort (Greenway et al. International Clinical Psychopharmacology 2021; 36 218-220).

The primary objective is to evaluate and compare the subjective clinical efficacy of two different types of music during ketamine-assisted group therapy. This will be explored through various validated psychiatric questionnaires, including the PHQ-9, GAD-7, and PCL-5. The secondary objective is to compare the objective changes in brain activity between the two music types. This will be evaluated using EEG data collected from MUSE headband before and after each ketamine-assisted therapy session.

This study is a crossover trial of 32 participants undergoing ketamine-assisted therapy for treatment-resistant mental health conditions. Half of participants will undergo a KAT session with a “weightless” music playlist followed by a session with a “grounding” music playlist. The other half will do the same, in reverse order. All participants will complete several psychiatric questionnaires within 7 days of each session over email. Before and after each session, participants will play a simple game to test executive function while wearing a headband to measure EEG activity.

The absolute and relative changes to the scores of the questionnaires will be examined between participants and music conditions. The change in brain activity from pre-session to post-session will be compared between the different music conditions as well. As this is a crossover trial, any changes in outcomes due to order effects will be controlled for. Relevant demographic and medical factors will also be controlled for.

To date, no studies have explored the influence that different types of music have on patients experience with KAT in a group therapy setting. With the results of this study, we hope to fine tune and improve the use of music in future KAT administration.

None Declared

This quality improvement (QI) programme was proposed to integrate co-production principles into rehabilitation psychiatry, focusing on enhancing patient-centred care and promoting positive step-down discharges within the mental health system. The backdrop of the QI programme was the essential role of rehabilitation psychiatry in aiding the recovery and reintegration of individuals with mental health challenges, and sub-optimal audit results about patient’s attendance and positive step-down discharges at an in-patient psychiatric unit.

The QI programme aimed to implement and explore Co-production, a transformative approach involving patients and healthcare professionals as equal partners.

• - To promote co-production in psychiatric in-patient service

• - To improve patient experience in the CPA meetings

• - To reduce anxiety associated with the CPA meetings and discharge planning

• - To assess staff’s limitations and barriers in promoting co-production.

The QI programme was divided into phases, including diagnostic, problem-solving, and evaluation. It employed diagnostic tools such as the fishbone cause and effect diagram and the 5-Why Technique for root cause analysis. The project’s aim was aligned with the Model of Improvement, guided by the three fundamental questions. Change ideas were developed using driver’s diagram and were then evaluated through PDSA cycles. Quantitative analysis utilized paired t-tests to assess the significance of changes, and qualitative analysis focused on patient perspectives gathered through the co-produced CPA questionnaire. Emerging themes from the questionnaire responses were integrated into the project’s trajectory through narrative synthesis. Predictions were formulated to measure project success: 50% patient attendance in the next CPA meetings, 70% positive step-down discharges, and improved Hamilton Anxiety Rating Scale (HAM-A) scores.

The iterative Plan-Do-Study-Act (PDSA) cycles demonstrated the evolving impact of interventions on patient engagement and discharge outcomes. Implementation of patient information leaflets, staff training, and a CPA agenda template led to increased attendance and positive step-down discharges. Analysis of HAM-A scores revealed a substantial decline in anxiety levels for almost all participants, suggesting the effectiveness of the interventions. Discharge outcomes were influenced by patient engagement and tailored interventions. Patient responses revealed themes such as challenges during transitions to community care, empowerment from shared decision-making, and diverse experiences in communication with healthcare professionals.

The CPA agenda template improved patient experiences by enhancing communication and patient-centeredness.

None Declared

In this review, medication incidents accross different mental health care facilities was reviewed and nuances, challenges, and advancements in the administration and management of psychiatric medications was noted. Through gaining a better understanding of the complexities surrounding these incidents, valuable information can be gathered that will enhance patient safety, improving healthcare practices, and fostering a deeper understanding of the critical intersection between mental health care and medication management.

To identify the most frequent types of medication errors or patterns of medication errors in a mental health service accross different settings including inpatient, outpatient, liaison and long term residential unit

This is a multicentre project as it covers medication incidents in mental health care in a regianal area in Ireland. It includes an acute psychiatric Unit, the General Hospital and patients admitted in medical and surgical wards and as well long term residential care. Using the National Incident Management System we collected National Incident Report Forms (NIRF) relating mental health care provided and medication prescribed within a region in Ireland. From these we selected the ones were medication hazard was noted. Data collection happened between July 2020 and July 2021. A statuystical analysis was then performed to identify any patterns to medication errors.

A total of 22 incidents were included. On review of these, it was noted, among other findings, that here was a significant increase in the frequency of medication errors during the month of December. It was also noted errors ranged from medication being given to the wrong patient, medication being given twice and medication being missed.

Minimising medication errors requires a comprehensive, multidisciplinary approach that involves healthcare providers, patients, and healthcare systems. Healthcare organizations should foster a culture of safety where medication errors are seen as preventable and where providers are encouraged to report errors without fear of retaliation.

None Declared

Nurse-patient relationships and interactions during inpatient care evoke feelings of empathy and compassion. Compassion can lead to satisfaction, but also to exhaustion. Compassion fatigue is a commonly used concept that signifies the exhaustion of healthcare personnel due to the specific activities and repeated exposure to the suffering of others. This manifests through physical and emotional over-tiredness, anxiety, anger and irritability, low vitality, social isolation, diminished sense of enjoyment of one’s career, cognitive disorders, and sleep disturbances.

To assess the level of compassion of the healthcare staff employed in a Romanian general hospital.

The study sample included 256 nurses working in a general hospital. To identify socio-demographic data we applied a specific questionnaire, and subsequently we also used the PROQOL scale (Professional Quality of Life Scale). All data were statistically analysed.

The majority of healthcare professionals in our sample belong to the 40-49 age group (39.45%). Regarding work experience in the healthcare system, the majority(43%) have been working for over 10 years. 78.52% of nurses reported a high level of compassion satisfaction. Burnout was not identified in the majority of our sample (54.3%). We noted that the number of the staff affected by compassion fatigue increases proportionally with the years of work experience (P=0.033).

A high level of compassion satisfaction in medical professionals leads to a remarkable improvement in the quality of the healthcare they are providing. However, our study results suggest that compassion fatigue tends to increase in line with the years of work in healthcare

None Declared

The process of recovery of mental reactions in children after acute traumatic brain injury is determined by complex methods with an interdisciplinary approach. Studies of emotional, communicative and behavioral reactions are based on an assessment by a psychiatrist and a teacher-defectologist.

to study mental reactions and identify predictors of positive recovery of consciousness after acute brain injury in children in early rehabilitation.

psychiatric and pedagogical examinations; also - neuroimaging data and others.

Three groups of children were identified, depending on the different severity of emotional, communicative and behavioral indicators:

Group 1 (11%): The level of consciousness is minimal positive. Reactions: stable gaze fixation; emotional reaction to sound (smile) and the face of an adult; short-term tracking of the gaze of the object; the ability to touch an object and hold it; sits himself.

Group 2 (33%): The level of consciousness is minimal positive / negative, with an advantage of positive. Reactions: unstable gaze fixation; emotional reaction and involuntary movements to sound; reflex seizure of an object; sits with support.

Group 3 (56%): The level of consciousness is minimal negative. Reactions: no emotional reactions, low motor and sensorimotor activity.

predictors of emotional-communicative and behavioral indicators of recovery of the level of consciousness were identified: sensory and motor, cognitive and socially-oriented (orienting reactions to the voice and face of an adult, tracking the gaze of an object, sensory and motor activity, etc.). These predictors are the basis for choosing a rehabilitation program with interdisciplinary support and a treatment strategy.

None Declared

Menopause marks a significant physiological transition in a woman’s life, often accompanied by various health challenges. Understanding the impact of physical activity on postural abilities in menopausal women is crucial for promoting their overall well-being during this transformative stage.

The aim of our study was to investigate the effect of a physical activity program on postural abilities, psychological well-being, and the quality of life of menopausal women.

Nineteen menopausal women, averaging 56±3 years of age, participated in a 12-week Zumba-style physical training program, consisting of three 50-minute sessions per week. The exercise regimen incorporated aerobic workouts, muscle conditioning, balance exercises, and flexibility training, predominantly inspired by Latin dances. Postural balance was evaluated using a stabilometric force platform, measuring the average velocity of the center of pressure (COPvm) under open eyes (OE) and closed eyes (CE) conditions on both firm and soft surfaces. Quality of life and mood were assessed using the SF-36 questionnaire (Short Form Survey-36) and the BMIS score (Brief Mood Introspection Scale). Assessments were conducted before (pre-test) and after (post-test) the 12-week training period.

The findings revealed a significant decrease in COPvm values in the post-test for both conditions (on a firm surface: OE p=0.05, CE p=0.01; on a soft surface: OE p=0.001, CE p=0.05). Additionally, improvements in mood (p=0.05) and quality of life (p=0.05) were observed compared to baseline values.

This study underscores the positive impact of Zumba-style physical training on postural abilities, mood, and quality of life among menopausal women. These results suggest that such exercise programs hold promise in reducing the risk and incidence of falls associated with menopause

None Declared

Deinstitutionalization has resulted in diverse mental health care models, influenced by local resources, funding, and cultural factors. In Italy, 127 Department of Mental Health (DMHs) provide care for individuals with mental disorders. People with severe mental disorders (SMD) live independently or in residential facilities (RFs). Approximately half of the Italian DMH budget is allocated to RFs, serving around 3.6% of people with SMD. Italian RFs prioritize personal recovery, empowering individuals with SMD to live fulfilling lives despite symptoms and psychosocial challenges. While personal recovery is known to improve well-being and cost-effectiveness, its implementation in Italian RFs remains incomplete. There is insufficient evidence regarding its impact on various outcomes for residents, including health, psychosocial, and biological factors.

The EMPOWER Study aims to assess whether adding personal recovery to Treatment As Usual (TAU) in Italian RFs could improve functioning (primary outcome), health, biological status, productivity and interpersonal relationships (secondary outcomes) among patients receiving the personal recovery-oriented treatment, compared with TAU. Additionally, data will be collected from informal caregivers, mental health professionals, and concerning the recovery orientation of RFs.

This study employs a longitudinal cohort design, gathering data at baseline and six-month follow-up in Italian RFs. A cohort of residents over 18 y.o. who receive a personal recovery-oriented treatment, the Mental Health Recovery Star (N=20), is compared to a matched group of residents receiving the TAU (N=20). International standardized assessments collect patients’ data on functioning, psychopathology, need for care, quality of life (QoL), positivity, social network, service satisfaction, and patient stigma. Informal caregivers’ data includes burden, QoL, positivity, and service satisfaction. Mental health professionals’ data encompasses burnout, stress, stigma, positivity, and work satisfaction. The working alliance between professionals and patients is assessed. Clinical and biological exams (blood and saliva samples) are collected, along with actigraphy data on patients’ circadian rhythm and physical activities. Digital data through a mobile app captures psychopathology, productive activities, social network, using the Experience Sampling Method with questions defined with patients. Focus groups with patients, professionals, and informal caregivers are facilitated by an expert by experience. Recovery orientation of RFs is assessed.

Not yet available.

This study aims to generate novel insight that could improve our treatment approaches for patients in residential facilities.

None Declared

In mental health prevention, person-centered, and rights-based approaches, the role of recovery is highlighted (WHO, 2021). Various evaluation tools are used in rehabilitation objectives and programs, including the Specific Levels of Functioning Scale (SLOF) (Mucci et al. Schizophr Res 2014;159 144-50) and the Recovery Assessment Scale – Domains and Stages (RAS-DS), a self-measure of mental health recovery. It includes 38 items clustered into four recovery domains and meets two functions. In addition to measuring self-reported outcomes, it increases service-user control towards objectives and recovery action plans (Honey et al. BMC Psychiatry 2023;23 500).

To evalue the efficacy of RAD-DS in a psychiatric rehabilitation facility to be used as a routine tool in daily rehabilitation activity.

In our observational study, we recruited 103 inpatients (total: 103 patients, females: 38 patients, males: 65 patients) in a psychiatric rehabilitation facility. The patient presented with psychiatric disorders that met the diagnostic criteria of DMS-5 (schizophrenia, bipolar disorder, MDD, personality borderline disorder). Epidemiological data are shown in Table 1.

All patients were undergoing a psychiatric rehabilitation program and were observed during a one-year evaluation.

In all patients, the following rating scales were administered at baseline (T0) and after a year (T1):

For the evaluation of social measures, life outcomes, and functioning and recovery:

• - Recovery Assessment Scale – Domains and Stages RAS-DS

• - Specific Levels of Functioning Scale (SLOF)

• - Global Assessment of Functioning (GAF)

For psychopathological evaluation:

• - Brief Psychiatric Rating Scale (BPRS)

The data were statistically analyzed with the EZAnalyze 3.0 software for the Excel platform.

The RAS-DS total score results (Table 2) show a not significant difference between T0 vs. T1 (mean: 101.80 vs. 104.37, p. 0.193). An improvement in the score was observed after one year of rehabilitation treatment in the subgroup “Doing things I value” (T0 vs. T1: mean 16.15 vs. 18.77, p 0.001). Statistically significant differences were observed in the subgroups “Mastering my illness” (T0 vs. T1: mean 18.3 vs. 20.85, p. 0.021). In the other subgroups, the differences were not statistically significant. Interestingly, these results are comparable to those found with SLOF and GAF (respectively, p. 0.972 and p. 0.873).

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The current trend of research and clinical practice is to give more importance to psychiatric rehabilitation treatment (Franza Psychiatr Danub 2022;34(Suppl 8) 9-13). The results obtained with our observational study indicate the possible usefulness of indicators of patient well-being, as well as the RAS-DS in the management of psychiatric rehabilitation programs. The expectations, indications, and perceptions of psychiatric patients can be decisive in improving recovery.

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